AVP, Actuarial Services
Position Title: AVP, Actuarial Strategy - Government Programs
Location: Remote
Position Overview
This leadership role is responsible for shaping actuarial strategy and execution across government-sponsored health plans, including Medicare Advantage and state-funded programs. The position oversees pricing, forecasting, and financial performance for a portfolio representing hundreds of thousands of covered lives and billions in annual revenue. A key contributor to enterprise-wide strategy, this role drives innovation in value-based contracting and ensures regulatory compliance through accurate and timely filings.
Core Responsibilities
- Lead the development of pricing models and strategic actuarial frameworks for Medicare and state-sponsored health plans.
- Oversee bid submissions, premium rate filings, and financial projections in alignment with regulatory requirements and organizational goals.
- Serve as a strategic advisor on government program performance, collaborating with cross-functional teams to optimize profitability and member outcomes.
- Manage and mentor a high-performing actuarial team, fostering professional growth and succession planning.
- Support risk adjustment forecasting, valuation, and performance monitoring to ensure accurate revenue recognition.
- Partner with finance, product, and clinical teams to develop multi-year strategies and segment action plans that meet margin targets.
- Design and implement reporting tools that support decision-making across government programs.
- Act as the primary point of contact for analytics related to government-sponsored plans, identifying trends, risks, and opportunities for improvement.
- Provide actuarial support to product and account management teams, including financial impact assessments and coding accuracy initiatives.
Qualifications
Education & Credentials
- Bachelor's degree in Actuarial Science, Mathematics, Economics, or a related field.
- Fellow of the Society of Actuaries (FSA) strongly preferred; ASA with significant experience considered.
Experience & Skills
- 12+ years of actuarial experience with FSA, or 15+ years with ASA
- Deep expertise in Medicare Advantage pricing, product design, and regulatory compliance.
- Proven ability to lead complex projects and influence enterprise strategy.
- Strong analytical skills, with experience in risk modeling and provider contracting impact analysis.
- Exceptional communication skills, capable of presenting complex findings to senior leadership and external stakeholders.
- Demonstrated leadership in team development, performance management, and succession planning.
- Proficiency in Microsoft Office Suite and actuarial software tools.
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